Suicide rates in China during a decade of rapid social changes

Background China accounts for more than 30% of the world's suicides and displays a unique pattern of suicide rates. Prior research had established the link between macrosocial changes and suicide. Comprehensive surveillance system of suicide in this rapidly developing country is much needed. This paper examined the trends of national-, region-, gender-, and age- specific suicide rates, and male to female ratios in suicide in China for the period of 1991 - 2000, which was a time that rapid economic and social changes took place. Methods A regression model was used to detect any variations in national-, region-, gender-, and age- specific suicide rates and gender ratios reported by the most recent mortality statistics from China's Ministry of Health. Results National, urban, and rural suicide rates for both men and women decreased significantly for the period of 1991 - 2000; age- specific suicide rates, however, showed that there were different patterns of changes in suicide rates in rural and urban areas. Although elderly suicide rates showed the most significant decrease in urban areas, younger women showed the largest decrease in rural areas; male to female gender ratio in suicide increased significantly in the urban areas, but no significant change was found in rural areas. Conclusions Possible explanations that may account for the downward trends in suicide rates and increase in male to female gender ratio in urban area were provided. Longer historical studies are needed to reveal the relationship between macrosocial changes and the pattern of suicide.